in this video I walk you through the fascinating and complex pathway that lymph has before it gets back into our bloodstream in many parts of our body we can see this very small structures they look like tiny kidneys and we name them lymph nodes in a separate videos I introduce you to the name of this lymph nodes and we talk about their location more but for now I see that the lymph nodes are connected to one another by lymphatic vessels and when I follow these lymphatic vessels I see that from a very large part of the body for example head and neck these lymphatic vessels join together and eventually they empty their lymph into a larger and long vessel that is called lymphatic trunk for example here I can follow a trunk that is the jugular trunk as you can see parallel to internal jugular vein we can find the jugular trunk clearly the difference is that jugular trunk flows lymph but internal jugular vein is the one for circulation of deoxygenated blood so when I follow the lymph that we get from head and neck we see that the lymph from head and neck will be released into the jugular trunk and we have two jugular trunks that's the right jugular trunk and this would be the left jugular trunk and we see that these trunks are moving toward this area exactly the area that subclavian vein and internal jugular vein join together the reason is that near the junction of subclavian vein and internal jugular vein we expect lymph to get back into the venous system so all the lymph that we collect from different parts of the body eventually should get back exactly to this spot the junction of subclavian vein and internal jugular vein after learning that the jugular trunks drained limb from head and neck and we have two of them then we follow the lymph that flows through our Upper Limb shoulder and all these lymph nodes that we have in axillary region and we see that limb from this area will be emptied into the subclavian trunk so when I follow the subclavian trunk I see that in this model the right subclavian trunk joins the right jugular trunk and here I have the left subclavian trunk as you can see it's moving toward the junction of the veins on the left side we have Bronco mediastinal trunks I have a very good view of the right bronchial mediastinal trunk and I follow bronchomedia signal trunk the right one collection from the wall of the thoracic region obviously on the right side the right lung and keep in mind that part of the heart is located here some Airways for example I can see the primary bronchus the right one I can see trachea in this spot so limp from all these structures in the right side will be emptied into the right bronchial media cinal trunk and then I followed the bronchomedia cyanide trunk I see it goes up and right bronchometersonal trunk in this model joins the right jugular trunk and right subclavian so when these three join together we have a very short duct that is called right lymphatic duct it's very short it's just about 1.2 centimeters and as you see right lymphatic duct empties lymph that it receives from right subclavian right jugular and right bronchial mediastinal into the venous system near the junction of right subclavian vein and right internal jugular vein so we can say that the lymph that we collect from right side of the head neck right Upper Limb shoulder axillary region and right side of the thoracic region will be emptied into the right lymphatic duct however it is important to note that in many individuals these three trunks do not join together basically in this individuals we do not form the right lymphatic duct instead these three Trunks fuse to especially the subclavian vein and empty the lymph directly into the venous system near the junction of these two veins however in this model we have the right lymphatic duct now it's time to learn about the left lymphatic duct and since left lymphatic duct is a very long duct I would like to show you the beginning of this duct so I go all the way down to the abdominal region and exactly in front of Lumbar number two that's the vertebral bone in the lumbar region number two I can see a dilation that is called cisterna Kylie that's the beginning of left lymphatic duct and then I start left lymphatic duct eventually I get into the thoracic region I keep going up and as you see here I make a turn and that would be exactly the end of the left lymphatic duct near the junction of left internal jugular vein and left subclavian vein this is a very long duct it's about 45 centimeters as I mentioned it starts in cisterna Kylie which is in front of L2 and it ends near the junction of left subclavian vein and left internal jugular vein because most of these duct passes through the thoracic region we name it thoracic duct so now the question is from which part of the body we receive lymph in thoracic duct so I go down and I see I have two trunks that they collect lymph from the lower limb so when I follow all these lymphatic vessels that I get from the lower limb eventually I see from all these lymphatic vessels and lymph nodes lymph gets into lumbar trunk and I followed the lumbar trunk keep in mind we have two lumbar trunks one right and one left this model shows the right one much better I followed the lumbar trunk and then I see that lumbar trunks empty their lymph exactly into cisterna Kylie so I want you to pay attention exactly to this space which is between stomach and here I can see the common hepatic artery that send blood into the liver that's hepatic portal vein and that would be a bile duct so exactly in this space I want you to pay attention to three Pathways one two three that's the right lumbar trunk the one on the left is the left lumbar trunk and the one in the middle is a trunk that is called intestinal trunk all three of them empty their lymph into cisterna Kylie so if I change the angle you see that sister not Kylie received limbs from both lumbar Trunks and intestinal trunk which is in the middle so I go back to the lumbar trunk because lumbar trunk receive limbs from lower limb but when it gets here it also received limbs from the wall of the pelvic cavity the wall of the abdominal region it also received limbs from the structures that we have inside the pelvic cavity and even it receives lymph from structures such as kidneys and adrenal glands even though the model doesn't show adrenal glands but we know that it actually sits above kidney so from kidneys adrenal glands lower limb the pelvic region and the visceral organs here the wall of abdomen lymph will be emptied into the two lumbar Trunks and then lumbar trunks take the lymph into the beginning of thoracic duct now what about the middle trunk that I named it intestinal trunk keep in mind we have only one intestinal trunk uh lymph that we get from stomach spleen and we don't see pancreas because it's hidden behind and Below stomach I also see from part of the liver lymph gets into intestinal trunk and also from intestines so we have a very huge network of deeply located lymph nodes and lymphatic vessels that drain link from both large and small intestine so from all these areas lymph will be emptied into the intestinal trunk the middle trunk and intestinal trunk empty lymph into cisterna Kylie so cisternacle is so far received lymph from the two Lumbar and also the intestinal and now I follow the rest of thoracic duct when I go up exactly here I see that the left jugular trunk recall it brings limb from the left side of head and neck and also left subclavian trunk the one that collects lymph from the left lower Upper Limb and shoulder they empty their length into the thoracic duct and then thoracic duct empty lymph into the venous system near the junction of left subclavian vein and left internal jugular vein hopefully you noted that I did not say anything so far about the left Bronco mediastinal trunk so let's follow this one that collects limp from the left side of the thoracic region and all the structures that we have here when I follow the left bronchometal trunk as you can see it goes up I see it does not join thoracic duct that's very interesting the left bronchometersonal trunk actually attaches to the anterior surface of left subclavian vein and directly empty its lymph into the left subclavian vein